A trial looking at immunotherapy for mesothelioma of the lung (TILT)

Cancer type:

Lung cancer





This trial looked at 2 types of immunotherapy for pleural mesothelioma. 

It was open for people to join between 2018 and 2019. The team analysed the results in 2021.

More about this trial

Mesothelioma can start in the lining of the lungs or the abdomen. When it starts in the lining of the lungs it is called pleural mesothelioma.

Doctors often treat pleural mesothelioma with chemotherapy. But sometimes the cancer continues to grow or spreads to other parts of the body. 

Researchers wanted to see if a type of treatment called immunotherapy can help. They hoped the treatment would stimulate the immune system to kill the cancer cells. 
They looked at 2 treatments in this trial:

  • picibanil (OK-432)
  • BCG

Both of these treatments were already being used to treat other conditions. 

In this trial the treatments were given through a tube into the area around the lungs. The research team wanted to see if they would be helpful for people with mesothelioma.
First, they needed to do a small feasibility trial. The main aims of this were to find out:

  • if it’s possible to do a larger clinical trial
  • what people think about these treatments

Summary of results

This trial was for people with mesothelioma who were already taking part in a trial called ASSESS-meso.

The research team identified 7 people who were part of the ASSESS-meso trial and could also take part in TILT. This was less than they were hoping.

They were put into 1 of 3 treatment groups:

  • 1 person had picibanil
  • 3 people had BCG
  • 3 people had usual care

There wasn’t any difference in how well people did in the 3 groups. But it’s hard to say for sure because of the small number of people who took part.

The research team concluded it was not feasible to run a larger trial in this way, looking at these treatments for mesothelioma. But it has added to our understanding of how to design and run this type of trial.

More detailed information
There is more information about this research in the reference below. 

Please note, this article is not in plain English. It has been written for health care professionals and researchers.

Journal articles
A Trial of Intra-Pleural BacteriaL ImmunoTherapy In Malignant Pleural Mesothelioma (TILT) – A Randomised Feasibility Study Using The Trial Within A Cohort (TwiC) Methodology (version 2)
A Bibby and others
Research Square website, July 2021.
Accessed April 2022.

Where this information comes from    
We have based this summary on the information in the article above. This has been reviewed by independent specialists (peer reviewed Open a glossary item) and published on a medical journal website. We have not analysed the data ourselves. As far as we are aware, the link we list above is active and the article is free and available to view.

Recruitment start:

Recruitment end:

How to join a clinical trial

Please note: In order to join a trial you will need to discuss it with your doctor, unless otherwise specified.

Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Chief Investigator

Professor Nick Maskell

Supported by

National Institute for Health Research (NIHR)
North Bristol NHS Trust

If you have questions about the trial please contact our cancer information nurses

Freephone 0808 800 4040

Last review date

CRUK internal database number:


Please note - unless we state otherwise in the summary, you need to talk to your doctor about joining a trial.

Charlie took part in a trial to try new treatments

A picture of Charlie

“I think it’s really important that people keep signing up to these type of trials to push research forward.”

Last reviewed:

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